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NPI Code Detail

MEDICARE: BRADY'S PHARMACY

MEDICARE: BRADY'S PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistIL

General Provider Information

NPI Number : 1265537054
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRADY'S PHARMACY
Provider Business Mailing Address
First Line : 3235 W 111TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60655-2730
Country : US
Telephone Number : 773-238-6686
Fax Number : 773-238-7704
Provider Business Practice Location Address
First Line : 3235 W 111TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60655-2730
Country : US
Telephone Number : 773-238-6686
Fax Number : 773-238-7704
Authorized Official
Title or Position : OWNER
Name : MR. TIMOTHY A BRADY
Credential :
Telephone Number : 708-598-2882
Provider Enumeration Date : 09/14/2006
Last Update Date : 08/22/2020

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Directions to “BRADY'S PHARMACY ” Practice Location

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